# Worked Medical Scenario: Confidence as Action-Type Selector

## Patient A (Q3 — Informed Dilemma)
Troponin elevated, ECG normal. High confidence in evidence, mid strength on diagnosis.
NAL chain: chest_pain_patient->split_diagnostics (0.9/0.689) -> NSTEMI vs unstable_angina (0.72/0.386)
Q3 prescription: seek_cardiology_consult — QUALITATIVE SHIFT in reasoning mode.
More troponins will not resolve this. A different KIND of expert judgment is needed.

## Patient B (Q4 — Ignorance)
Chest pain, no labs yet. Low confidence, mid strength.
Q4 prescription: order_serial_troponins — QUANTITATIVE INCREASE in evidence.
You do not yet know enough to know WHAT KIND of thinking you need.

## The Distinction Standard Triage Misses
Both patients present as uncertain chest pain. Standard protocols treat them identically.
NAL truth values distinguish them: A has an INFORMED DILEMMA, B has IGNORANCE.
The confidence axis tells you WHETHER to change your approach or gather more data.